title: Current sickle cell disease management practices in Nigeria.
abstract: BACKGROUND
  Although Nigeria has the highest burden of sickle cell disease (SCD) worldwide, there is still variable and poor utilisation of standard-of-care practices for SCD patients in the country.
  
  
  METHODS
  This was a questionnaire survey of doctors in some dedicated SCD clinics in Nigeria in order to document the facilities available and common management practices.
  
  
  RESULTS
  There were responses from 18 clinics based in 11 institutions. The number of patients being followed in each centre ranged from 15 to approximately 11 000. All clinics provided malaria prophylaxis and folic acid routinely to their patients. Only eight clinics prescribe penicillin prophylaxis. Eight prescribe hydroxyurea to patients who can afford it when indicated. All of the centres except three have electronic cell counters, but all had access to haemoglobin electrophoresis. Three had high-performance liquid chromatography machines installed but none was being routinely used. One institution had a functioning molecular biology laboratory. There is no official newborn screening programme in the country. All had access to microbiology and chemistry laboratories. Nine institutions had CT, six had MRI and three had transcranial Doppler facilities.
  
  
  CONCLUSIONS
  The care available for SCD in Nigeria is still suboptimal and there is an urgent need for concerted effort to tackle the problem, but to make a significant impact on the burden of the disease would require more focus at the primary care level. Some steps to achieving this are outlined.
authors.affiliation: Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: N
authors.initials: N
authors.lastname: Galadanci
authors.forename: B J
authors.initials: BJ
authors.lastname: Wudil
authors.forename: T M
authors.initials: TM
authors.lastname: Balogun
authors.forename: G O
authors.initials: GO
authors.lastname: Ogunrinde
authors.forename: A
authors.initials: A
authors.lastname: Akinsulie
authors.forename: F
authors.initials: F
authors.lastname: Hasan-Hanga
authors.forename: A S
authors.initials: AS
authors.lastname: Mohammed
authors.forename: M O
authors.initials: MO
authors.lastname: Kehinde
authors.forename: J A
authors.initials: JA
authors.lastname: Olaniyi
authors.forename: I N
authors.initials: IN
authors.lastname: Diaku-Akinwumi
authors.forename: B J
authors.initials: BJ
authors.lastname: Brown
authors.forename: S
authors.initials: S
authors.lastname: Adeleke
authors.forename: O E
authors.initials: OE
authors.lastname: Nnodu
authors.forename: I
authors.initials: I
authors.lastname: Emodi
authors.forename: S
authors.initials: S
authors.lastname: Ahmed
authors.forename: A O
authors.initials: AO
authors.lastname: Osegbue
authors.forename: N
authors.initials: N
authors.lastname: Akinola
authors.forename: H I O
authors.initials: HI
authors.lastname: Opara
authors.forename: S A
authors.initials: SA
authors.lastname: Adegoke
authors.forename: J
authors.initials: J
authors.lastname: Aneke
authors.forename: A D
authors.initials: AD
authors.lastname: Adekile
mesh_terms: D000755:Anemia, Sickle Cell / Q000628:therapy*; D003695:Delivery of Health Care / Q000592:standards*; D019538:Health Care Surveys; D006268:Health Facilities; D006295:Health Resources; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D007231:Infant, Newborn; D015997:Neonatal Screening; D009549:Nigeria; D011320:Primary Health Care / Q000592:standards*; D011795:Surveys and Questionnaires
chemical_list: D006918:Hydroxyurea
keywords: Future projections; Management; Nigeria; Sickle cell disease